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目的为经皮“瓣上瓣”支架植入治疗急性主动脉瓣膜关闭不全提供相关应用解剖。方法解剖5例外形大小正常的成年人心脏和升主动脉的标本;回顾性分析178例升主动脉CTA病人影像资料,其中男性131例,女性47例,以及85例主动脉瓣上造影(DSA)病人资料,其中男性45例,女性40例,测量不同位置升主动脉的内径及长度。结果根据升主动脉CTA测得D1、D2、L1、L2分别为(30.5±2.3)、(25.5±1.8)、(36.5±3.6)、(31.2±4.1)mm,经体表面积标准化后得出的SD1、SD2、SL1、SL2分别为(17.1±1.2)、(14.2±0.9)、(21.4±1.1)、(17.8±1.3)mm;根据升主动脉DSA测量得出的D1’、D2’、L1’、L2’分别为(28.7±2.8)、(24.4±2.1)、(34.3±2.9)、(29.4±3.6)mm,经体表面积标准化后得出SD1’、SD2’、SL1’、SL2’分别为(16.0±1.4)、(13.5±1.2)、(19.7±1.6)、(16.7±2.0)mm。结论经皮主动脉“瓣上瓣”支架具有成功的动物实验研究背景,可作为一种新技术用于临床,其瓣膜支架的大小和形状的设计应根据升主动脉段的内径和长度来选择。
The purpose of this study is to provide relevant anatomy for the treatment of acute aortic valve insufficiency by percutaneous flap embedding. METHODS: Five cases of adult heart and ascending aorta with normal size were dissected. The imaging data of 178 patients with ascending aortic CTA were retrospectively analyzed. There were 131 males and 47 females, and 85 patients underwent aortic valve angiography (DSA) ) Patient information, including 45 males and 40 females, measuring the diameter and length of the ascending aorta at different locations. Results According to the CTA of ascending aorta, the values of D1, D2, L1 and L2 were (30.5 ± 2.3), (25.5 ± 1.8), (36.5 ± 3.6) and (31.2 ± 4.1) mm, respectively, SD1, SD2, SL1 and SL2 were (17.1 ± 1.2), (14.2 ± 0.9), (21.4 ± 1.1) and (17.8 ± 1.3) mm respectively; D1 ’, D2’, and L1 ’And L2’ were (28.7 ± 2.8), (24.4 ± 2.1), (34.3 ± 2.9) and (29.4 ± 3.6) mm, respectively. SD1 ’, SD2’, SL1 ’and SL2’ were obtained after body surface area standardization (16.0 ± 1.4), (13.5 ± 1.2), (19.7 ± 1.6), (16.7 ± 2.0) mm. Conclusion The percutaneous aortic valve flap has a successful animal experimental background, which can be used as a new technique in clinic. The size and shape of the valve support should be designed according to the diameter and length of the ascending aortic segment To choose.